[A version of this item appears in: Dementia: the Latest Evidence Newsletter (RWHT), Volume 3 Issue 2, September 2012].
Researchers attempted to estimate the prevalence of antipsychotic use for dementia in secondary mental health services in the UK and to assess the impact of quality improvement initiatives regarding antipsychotic prescribing practice for patients with dementia under the care of specialist older people’s mental health services.
This study looked at data about 10,199 patients, from fifty-four mental health National Health Service (NHS) trusts. Agitation, psychotic symptoms, aggression and distress resulted in 1620 (16%) of these patients without comorbid psychotic illness being prescribed an antipsychotic. Younger age, a care home or an in-patient setting, vascular or Parkinson’s disease dementia and greater severity of dementia are significantly associated with being prescribed antipsychotic medication. Of the 1001 (62%) patients prescribed treatment for more than 6 months, only three-quarters had a documented review during the previous 6 months.
There are some aspects of relatively good current practice, including consideration of alternatives to antipsychotic medication and clear documentation of target symptoms, but the authors suggest some potential improvements; including the frequency and quality of reviews of long-term antipsychotic medication. Strategies to reduce antipsychotic use should take account of the demographic and clinical factors associated with an increased likelihood of antipsychotic prescription (above).
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Barnes, TR. Banerjee, S. [and] Collins, N. [et al] (2012). Antipsychotics in dementia: prevalence and quality of antipsychotic drug prescribing in UK mental health services. The British Journal of Psychiatry: the Journal of Mental Science, September 2012, 201, pp.221-6. [Epub July 12th 2012]. (Click here to view the PubMed abstract).